2024 NURS 676 Advanced Pharmacology
Exam (WCU) Question And
Answers verified
What should be taken into consideration when prescribing fat-soluable drugs in the
elderly? - They are associated with increased duration of drug action.
Which hypolipidemic class of drugs does not have to have liver function studies? -
Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins)
FYI: I actually just looked this up because it didn't seem right...From the FDA: "The good
news—no more periodic blood tests for liver function. The warnings—taking a statin
may increase the odds of developing type 2 diabetes or suffering reversible memory
loss or problems thinking. The FDA warned that one statin, lovastatin, shouldn't be
taken with some antibiotics, anti-fungal agents, or medications used to treat AIDS."
What is the MOA of cardiac glycosides? - Increase the force of cardiac contraction.
What age-related changes place the elderly at risk for an exaggerated response to
Warfarin (Coumadin) and Heparin? - Protein binding changes and decrease in clotting
factors.
Along with diet, what drug is used to treat hypertriglyceridemia? - Gemfibrozil (Lopid).
What drug is the best choice of treatment for a newly diagnosed patient with type 2
diabetes only having postprandial glucose elevation? - Meglitinide (Prandin).
Which medication is considered the safest for a diabetic patient if hypoglycemia is a
major concern? - Metformin (Glucophage).
What drug is an absolute contraindication if the patient is a smoker and taking
medications for type 2 diabetes? - Birth control.
How should an oral glucocorticoid be taken? - With food.
The normal starting dose of levothyroxine is 50-100mcg per day for primary
hypothroidism. What is the most appropriate starting dose in a 71-year old female
patient? - 25mcg per day.
,What drug class should be avoided in patients with a diagnosis of osteopenia or
osteoporosis? - Clucocorticoids like Prednisone.
What thyroid drug blocks thyroid hormone production and release? - L-thyroxine
(Levothyroid).
What drug class exacerbates hyperglycemia? - Corticosteroids like Prednisone
(Deltasone).
Amenorrhea is the most common side effect of which birth control medication? -
Medroxyprogesterone (Depo-Provera)
What is an anti-hypertensive agent which competes with epinephrine for available beta-
receptor sites? - Atenolol (Tenormin)
What type of action does nitrates have on the body? - Reduction in systemic venous
tone.
What is the recommended level of low-density lipoprotein cholesterol (LDL) for patients
with known coronary artery disease? - 100mg/dl or less.
What is the MOA of group IV anti-dysrhythmia drugs? - Depressing phase 4
depolarization and lengthening phases 1 and 2 repolarization.
Which drug therapy should be used to lower the serum concentration of thyroid
hormones and re-establish eumetabolic state in a patient with Graves' disease? -
Antithyroid drugs.
Which type of diuretic would be used for a stage I hypertension in a patient with renal
insufficiency? - Loop diuretic.
What drug should be considered as first-line therapy for a client with hypertension and
heart failure? - Enalapril (Vasotec)
Which drug is considered safe for hypertension treatment during pregnancy? -
Methyldopa (Aldomet)
What drug will reduce afterload because it is an alpha-adrenergic blocker? - Prazosin
,(Minipress)
What is an expected effect of the use of a beta-adrenergic blocker to control angina? -
Reduced force of cardiac contraction.
What side effect should be monitored closely in the elderly when taking Metformin
(Glucophage) for type 2 diabetes? - Lactic acidosis.
What is the primary role of cytochrome p-450 in the liver? - Deactivate and detoxify
medications and other substances.
What is a component of Vitamin K-dependent clotting factors? - Prothrombin
How are IV morphine and nitroglycerin beneficial in acute heart failure? - Decrease
preload.
What is the purpose of administering a vasodilating drug to a patient in heart failure? -
Decrease afterload.
Why are nitrate-free periods every 24 hours necessary for the patient on nitroglycerin
therapy? - To inhibit the development of tolerance
What does a low level of thyroid-stimulating hormone indicate? - Hyperthroidism
What would be the best option to treat a newly diagnosed patient with a low TSH level
with? - Propanolol (Inderal)
Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - Aldosterone
antagonist
Heparin exerts its therapeutic action by what? - Upregulating the activity of one of the
body's natural anticoagulant molecules, antithrombin III
What physiologic action happens when the offending drug is administered during an
anaphylactic reaction. - Mast cells liberate large doses of histamine.
What are two systemic psoriasis medications? - Photo-therapy and topical
corticosteroids
What is the first choice of drug therapy for the majority of patients with uncomplicated
stage I hypertension? - Thiazide diuretics
, What is the effect of cardiac glycosides? - Digitalis glycosides have a negative
chronotropic effect on the cardiac muscle cells.
What are some contrindications for HMG-co A reductase inhibitors (statins)? - They
cause myopathies, especially at higher doses or in combination with certain drugs.
They should never be used in patients taking Warfarin (Coumadin).
Which drug can reduce serum LDL the most in patients with hyperlipidemia? -
Lovastatin (Mevacor)
Which drug is contrindicated in a patient with Myasthena Gravis? - Procainamide
(Pronestyl).
What action is most effective in decreasing the risk of hyperkalemia associated with the
start of angiotensin-converting enzyme inhibitor (ACEI) therapy? - Making sure that the
patient is well hydrated.
What factor influences plasma protein drug binding and distribution of that drug? - The
amount of albumin available in the blood stream.
What does the half-life of a medication determine? - How often the drug is to be
administered.
What important information should be given to a patient who is taking Metoprolol
(Lopressor) for angina and hypertension? - The drug should not be taken with milk or
dairy products.
Which medications should be avoided for patients with a sulfa allergy? -
Sulfamethoxazole/Trimethoprim (Bactrim) and Celecoxib (Celebrex).
What drug would you add for a patient who has been taking a sulfonylurea medication
like Glipizide (Glucotrol) for type 2 diabetes when there is poor glucose control? - Add
Metformin (Glucophage) to the sulfonylurea.
Which drug class may predispose an insulin dependent patient to hypoglycemia? - A
selective beta-adrenergic blocker like Nadolol (Corgard).
What side effects may an elderly patient who has just been placed on a calcium channel
blocker for treatment of hypertension and angina except to watch for? - Constipation,
peripheral edema, and decreased heart rate.
Exam (WCU) Question And
Answers verified
What should be taken into consideration when prescribing fat-soluable drugs in the
elderly? - They are associated with increased duration of drug action.
Which hypolipidemic class of drugs does not have to have liver function studies? -
Hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins)
FYI: I actually just looked this up because it didn't seem right...From the FDA: "The good
news—no more periodic blood tests for liver function. The warnings—taking a statin
may increase the odds of developing type 2 diabetes or suffering reversible memory
loss or problems thinking. The FDA warned that one statin, lovastatin, shouldn't be
taken with some antibiotics, anti-fungal agents, or medications used to treat AIDS."
What is the MOA of cardiac glycosides? - Increase the force of cardiac contraction.
What age-related changes place the elderly at risk for an exaggerated response to
Warfarin (Coumadin) and Heparin? - Protein binding changes and decrease in clotting
factors.
Along with diet, what drug is used to treat hypertriglyceridemia? - Gemfibrozil (Lopid).
What drug is the best choice of treatment for a newly diagnosed patient with type 2
diabetes only having postprandial glucose elevation? - Meglitinide (Prandin).
Which medication is considered the safest for a diabetic patient if hypoglycemia is a
major concern? - Metformin (Glucophage).
What drug is an absolute contraindication if the patient is a smoker and taking
medications for type 2 diabetes? - Birth control.
How should an oral glucocorticoid be taken? - With food.
The normal starting dose of levothyroxine is 50-100mcg per day for primary
hypothroidism. What is the most appropriate starting dose in a 71-year old female
patient? - 25mcg per day.
,What drug class should be avoided in patients with a diagnosis of osteopenia or
osteoporosis? - Clucocorticoids like Prednisone.
What thyroid drug blocks thyroid hormone production and release? - L-thyroxine
(Levothyroid).
What drug class exacerbates hyperglycemia? - Corticosteroids like Prednisone
(Deltasone).
Amenorrhea is the most common side effect of which birth control medication? -
Medroxyprogesterone (Depo-Provera)
What is an anti-hypertensive agent which competes with epinephrine for available beta-
receptor sites? - Atenolol (Tenormin)
What type of action does nitrates have on the body? - Reduction in systemic venous
tone.
What is the recommended level of low-density lipoprotein cholesterol (LDL) for patients
with known coronary artery disease? - 100mg/dl or less.
What is the MOA of group IV anti-dysrhythmia drugs? - Depressing phase 4
depolarization and lengthening phases 1 and 2 repolarization.
Which drug therapy should be used to lower the serum concentration of thyroid
hormones and re-establish eumetabolic state in a patient with Graves' disease? -
Antithyroid drugs.
Which type of diuretic would be used for a stage I hypertension in a patient with renal
insufficiency? - Loop diuretic.
What drug should be considered as first-line therapy for a client with hypertension and
heart failure? - Enalapril (Vasotec)
Which drug is considered safe for hypertension treatment during pregnancy? -
Methyldopa (Aldomet)
What drug will reduce afterload because it is an alpha-adrenergic blocker? - Prazosin
,(Minipress)
What is an expected effect of the use of a beta-adrenergic blocker to control angina? -
Reduced force of cardiac contraction.
What side effect should be monitored closely in the elderly when taking Metformin
(Glucophage) for type 2 diabetes? - Lactic acidosis.
What is the primary role of cytochrome p-450 in the liver? - Deactivate and detoxify
medications and other substances.
What is a component of Vitamin K-dependent clotting factors? - Prothrombin
How are IV morphine and nitroglycerin beneficial in acute heart failure? - Decrease
preload.
What is the purpose of administering a vasodilating drug to a patient in heart failure? -
Decrease afterload.
Why are nitrate-free periods every 24 hours necessary for the patient on nitroglycerin
therapy? - To inhibit the development of tolerance
What does a low level of thyroid-stimulating hormone indicate? - Hyperthroidism
What would be the best option to treat a newly diagnosed patient with a low TSH level
with? - Propanolol (Inderal)
Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - Aldosterone
antagonist
Heparin exerts its therapeutic action by what? - Upregulating the activity of one of the
body's natural anticoagulant molecules, antithrombin III
What physiologic action happens when the offending drug is administered during an
anaphylactic reaction. - Mast cells liberate large doses of histamine.
What are two systemic psoriasis medications? - Photo-therapy and topical
corticosteroids
What is the first choice of drug therapy for the majority of patients with uncomplicated
stage I hypertension? - Thiazide diuretics
, What is the effect of cardiac glycosides? - Digitalis glycosides have a negative
chronotropic effect on the cardiac muscle cells.
What are some contrindications for HMG-co A reductase inhibitors (statins)? - They
cause myopathies, especially at higher doses or in combination with certain drugs.
They should never be used in patients taking Warfarin (Coumadin).
Which drug can reduce serum LDL the most in patients with hyperlipidemia? -
Lovastatin (Mevacor)
Which drug is contrindicated in a patient with Myasthena Gravis? - Procainamide
(Pronestyl).
What action is most effective in decreasing the risk of hyperkalemia associated with the
start of angiotensin-converting enzyme inhibitor (ACEI) therapy? - Making sure that the
patient is well hydrated.
What factor influences plasma protein drug binding and distribution of that drug? - The
amount of albumin available in the blood stream.
What does the half-life of a medication determine? - How often the drug is to be
administered.
What important information should be given to a patient who is taking Metoprolol
(Lopressor) for angina and hypertension? - The drug should not be taken with milk or
dairy products.
Which medications should be avoided for patients with a sulfa allergy? -
Sulfamethoxazole/Trimethoprim (Bactrim) and Celecoxib (Celebrex).
What drug would you add for a patient who has been taking a sulfonylurea medication
like Glipizide (Glucotrol) for type 2 diabetes when there is poor glucose control? - Add
Metformin (Glucophage) to the sulfonylurea.
Which drug class may predispose an insulin dependent patient to hypoglycemia? - A
selective beta-adrenergic blocker like Nadolol (Corgard).
What side effects may an elderly patient who has just been placed on a calcium channel
blocker for treatment of hypertension and angina except to watch for? - Constipation,
peripheral edema, and decreased heart rate.
